Organization Active NPI

Luna Y Sol Life Services

  • Marriage & Family Therapist
  • Roswell, NM
National Provider Identifier
1083135552
Registry record updated Jul 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
LUNA Y SOL LIFE SERVICES
Practice address
2001 W 4TH St
Roswell, NM 88201-1752
Phone
(575) 626-6349
NPI assigned
Jul 5, 2017
Last updated
Jul 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Teresa Gray, PLCSW
Title
Owner/Manager/Provider
Phone
(575) 626-6349

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

2001 W 4TH St
Roswell, NM 88201-1752

Mailing address

PO Box 2773
Roswell, NM 88202-2773
Phone (575) 626-6349

Other identifiers 1

IdentifierTypeStateIssuer
1245620400MedicaidNM

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499212800000",
    "number": "1083135552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2773",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882022773",
            "telephone_number": "575-626-6349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 4TH ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882011752",
            "telephone_number": "575-626-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNA Y SOL LIFE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-05",
        "last_updated": "2017-07-05",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "OWNER/MANAGER/PROVIDER",
        "authorized_official_telephone_number": "575-626-6349",
        "authorized_official_credential": "PLCSW"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245620400",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.